Remote Medical biller Jobs in Huntington Beach, CA

Details

Client Name

Hoag Memorial - Red Hill Clinic

Job Type

Local

Offering

Non-Clinical

Profession

Medical Biller

Specialty

Hospital

Job ID

16575823

Job Title

Medical Biller - Hospital

Weekly Pay

1220.0

Shift Details

Shift

5x8 Days

Scheduled Hours

Job Order Details

Start Date

07 / 07 / 2025

End Date

01 / 03 / 2026

Duration

26 Week(s)

Job Description

Medical Collector

Pride Health is hiring a Medical Collector for one of its clients in California.

This is a 6-month contract with competitive pay and benefits.

Location - Costa Mesa, California- 92626

Pay range - $28 - $32 per hour.

Length of assignment - 6 months contract (possibility to extend)

Shift - M-F 8 am-4 : 30 pm; 100% onsite.

Job Summary

The Collector serves as the account representative for the Client in working with insurance companies, government payors, and / or patients for the resolution of payments and accounts resolution.

Job Duties

• Completes assigned accounts within assigned work queues.
• Obtains the maximum amount of reimbursement by evaluating claims at the contract rate with the use of the contract management tool for proper pricing (Examples : APC, DRG, APRDRG).
• Reviews and initiates the initial appeal for underpayments, observing all timely requirements to secure reimbursement due to Hoag.
• Reviews and completes payor and / or patient correspondence promptly.
• Escalates to the payor and / or patient accounts that need to be appealed due to improper billing, coding, and / or underpayments.
• Reports new / unknown billing edits to the direct supervisor for review and resolution.
• Has a strong understanding of the Revenue Cycle processes, from Patient Access (authorizations, admissions) through Patient Financial Services (billing & collections), including procedures and policies.
• They have a thorough knowledge of managed care contracts, current payor rates, and an understanding of terms and conditions, as well as Federal and State requirements.
• Interprets Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERAs) to ensure proper payment, as well as assists and educates patients and colleagues with an understanding of benefit plans.
• Understanding of hospital billing form requirements (UB04) and familiarity with the HCFA 1500 forms.
• Knowledge of HMO, POS, PPO, EPO, IPA, Medicare Advantage, Covered California (Exchange), capitation, commercial, and government payors (i.e., Medicare, Medi-Cal, Tricare, etc.), and how these payors process claims.
• Demonstrates knowledge of and effectively uses patient accounting systems.
• Documents all calls and actions taken in the appropriate systems.
• Accurately codes insurance plan codes.
• Establishes a payment arrangement when patients are unable to pay in full at the time payment is due.
• May review applicable cash rates, special rates, and applicable professional and employee discounts.
• May process bankruptcy and deceased patient accounts.

Requirements

Benefits

Pride Global offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.

Equal Opportunity Employer

As a certified minority-owned business, Pride Global and its affiliates - including Russell Tobin, Pride Health, and Pride Now - are committed to creating a diverse environment and are proud to be an equal-opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics.

Client Details

Address

2995 Red Hill Ave #100, Costa Mesa, CA 92626, United States

City

Costa Mesa

State

Zip Code

92626

Job Board Disclaimer

Pride Global and its entities offer eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k) retirement savings, life and disability insurance, an employee assistance program, legal support, auto and home insurance, pet insurance, and employee discounts with preferred vendors.